We are all stunned and saddened by the apparent suicide of actor and comedian Robin Williams and our collective hearts go out to his family, friends and fans. While we remember his enormous talent and the joy that he brought so many of us throughout his career, we should also take this time to engage in much-needed conversations about suicide and mental health.
According to reports, Mr. Williams was "battling severe depression." This is a striking statement because it reminds us that depression and mental health affect everyone. It doesn't discriminate based on gender, age, race or socio-economic status. We know from research that there is a strong link between suicide and depression, with 90 percent of the people who die by suicide having an existing mental illness or substance abuse problem at the time of their death.
Talking about suicide is the best way to prevent it. Although it is not possible to predict suicide with any certainty, our best tool is recognition of the signs that many people exhibit when contemplating suicide. The following three behaviors should prompt you to immediately call the National Suicide Prevention Lifeline at 1.800.273.TALK (8255) or a mental health professional:
- Talking about wanting to die or to kill oneself
- Looking for a way to kill oneself, such as searching online or obtaining a gun
- Talking about feeling hopeless or having no reason to live
Other behaviors may also indicate a serious risk—especially if the behavior is new; has increased; and/or seems related to a painful event, loss, or change:
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious or agitated; behaving recklessly
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
According to the National Suicide Prevention Lifeline, it is important to note that factors identified as increasing risk are not factors that cause or predict a suicide attempt. Risk factors are characteristics that make it more likely that an individual will consider, attempt, or die by suicide. Protective factors are characteristics that make it less likely that individuals will consider, attempt, or die by suicide.
Protective factors for suicide include:
- Receiving effective mental health care
- Positive connections to family, peers, community, and social institutions, such as marriage and religion, that foster resilience
- The skills and ability to solve problems
We cannot be afraid to talk about suicide or mental health issues. If you or a loved one is experiencing suicidal thoughts, please reach out to the National Suicide Prevention Lifeline at 1.800.273.TALK (8255) or a mental health professional.
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Dost Öngür, MD, PhD, is Chief of the Psychotic Disorders Division at McLean Hospital and an associate professor of psychiatry at Harvard Medical School.
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